Biomedical subjects

Yoshitaka Fujii

Publications and source records attributed to Yoshitaka Fujii.

At least 127 records · Page 7Linked to original sources

PubMed2002

Comparison of granisetron and ramosetron for the prevention of nausea and vomiting after thyroidectomy.

BACKGROUND: Postoperative nausea and vomiting (PONV) are common after thyroidectomy. Granisetron, a selective 5-hydroxytryptamine type 3 (5-HT3) receptor antagonist, is more effective than the traditional antiemetics droperidol and metoclopramide for the prevention of PONV after thyroidectomy. Ramosetron, another new selective antagonist of 5-HT3 receptor, has been shown to have more potent and longer-acting properties than granisetron against cisplatin-induced emesis in ferrets. OBJECTIVE: This study was undertaken to compare the efficacy and tolerability of granisetron and ramosetron for the prevention of PONV after thyroidectomy. METHODS: In this randomized, double-blind study, patients received granisetron 3 mg or ramosetron 0.3 mg intravenously at the end of surgery. A standard general anesthetic technique and postoperative analgesia were used. Emetic episodes and safety were assessed during the first 24 hours and the second 24 hours after anesthesia. RESULTS: Eighty patients (15 men, 65 women) aged 33 to 58 years were included in the study. Each study group consisted of 40 patients. There were no differences between groups with regard to patient demographics. The percentage of patients who were emesis free (no nausea, no retching, no vomiting) 0 to 24 hours after anesthesia was 83% (33 of 40) with granisetron and 88% (35 of 40) with ramosetron; the corresponding rates 24 to 48 hours after anesthesia were 63% (25 of 40) and 90% (36 of 40), respectively (P = 0.004). The safety profile of the two 5-HT3 receptor antagonists was comparable, as no clinically serious adverse effects caused by the study drug were observed in either of the groups. CONCLUSIONS: Prophylactic antiemetic therapy with ramosetron was comparable to therapy with granisetron for the prevention of PONV 0 to 24 hours after anesthesia in patients who underwent thyroidectomy; 24 to 48 hours after anesthesia, ramosetron was more ef- fective than granisetron for prophylaxis against PONV in this population.

Adult↗

PubMed2002

Expression of the MTA1 mRNA in advanced lung cancer.

The MTA1 gene is a recently identified metastasis-associated gene which has been implicated in the signal transduction or regulation of gene expression. We examined the mRNA expression levels of the MTA1, the human homologue of the rat mta1 gene in non-small cell lung cancer (NSCLC). Expression of MTA1 messenger RNA was evaluated by reverse transcription polymerase chain reaction (RT-PCR) in 74 non-small cell lung carcinoma samples using LightCycler. The data was analyzed in reference to clinicopathological data. There was no relationship between MTA1 gene expression and age and gender. MTA1/GAPDH mRNA level in stage II-IV NSCLC (3.465+/-3.675) was significantly higher than the level in stage I NSCLC (1.614+/-2.434, P=0.0153). MTA1/GAPDH mRNA levels in T4 NSCLC (4.377+/-4.169) was significantly higher than the level in T1 NSCLC (1.966+/-2.148, P=0.0351) and in T2 NSCLC (2.048+/-1.899, P=0.0269), respectively. MTA1/GAPDH mRNA level in NSCLC with lymph node metastasis (4.242+/-3.758) was significantly higher in NSCLC without lymph node metastasis (P=0.0169). Our results show that the expression of the MTA1 gene is closely related to invasiveness and metastasis in NSCLC. The gene MTA1 could thus potentially provide information on the mechanism of cancer invasion and metastasis.

Age Factors↗

PubMed2002

Decreased perioxisome proliferator-activated receptor gamma gene expression was correlated with poor prognosis in patients with lung cancer.

Activation of the nuclear hormone receptor perioxisome proliferator-activated receptor gamma (PPARgamma) inhibits cell growth and induces apoptosis in several human cancers. We have hypothesized that PPARgamma mRNA levels could be predictors of the differentiation and survival of lung cancer. The study included 77 lung cancer cases. The mRNA levels were quantified by real time reverse transcription-polymerase chain reaction (RT-PCR) using LightCycler. The PPARgamma mRNA levels were decreased in tumor tissues from lung cancer (0.579 +/- 1.255) compared to the normal adjacent lung tissues (4.191 +/- 2.868) (P = 0.0001). No significant difference in PPARgamma mRNA levels was found among gender, age, and pathological subtype. The PPARgamma mRNA levels were higher in tumor tissues from higher differentiated lung cancer. The NSCLC patients with low PPARgamma mRNA expression (< 0.5) had significantly worse survival than the patients without low PPARgamma mRNA levels (P = 0.0438, Breslow-Gehan-Wilcoxon test; P = 0.0168, Cox's proportional-Hazards regression model). Thus, PPARgamma mRNA levels may serve as a prognostic marker in lung cancer. Using the LightCycler RT-PCR assay, the determination of PPARgamma mRNA levels might provide a potential marker for treatment of lung cancer by PPARgamma agonist. However, further studies and a longer follow up are needed to confirm the impact of PPARgamma in the biological behavior of the tumor.

Adenocarcinoma↗

PubMed2002

Developmentally regulated expression of survivin in the human thymus.

Survivin is a member of the inhibitor-of-apoptosis (IAP) family. It has been reported to be expressed during development, but not in differentiated normal tissue. However, its expression has been reported to be high in the thymus. To assess the role of survivin in human thymocyte development, we investigated the expression of survivin using reverse-transcriptase-polymerase chain reaction, flow cytometry, and immunohistochemistry in freshly isolated human thymocytes. Survivin was expressed in all thymocyte subsets but its expression level was developmentally regulated. Its expression was low in the double negative (DN) thymocytes, upregulated in double positive (DP) thymocytes, and was highest in the T-cell receptor(high), late DP thymocytes; it was then downregulated in the single positive thymocytes and negative in the peripheral blood T cells. Moreover, there was a positive correlation between the expression of survivin and that of CD69 and Bcl-2 in DP thymocytes. These results suggest that survivin may play an important role in the T-cell development in the human thymus.

Antigens, CD↗

PubMed2002

Preoperative oral granisetron for the prevention of vomiting following paediatric surgery.

BACKGROUND: We evaluated the efficacy of granisetron, 5-hydroxytryptamine type 3 receptor antagonist, given orally, preoperatively, for the prevention of postoperative vomiting in children undergoing general anaesthesia for surgery (inguinal hernia, phimosis-circumcision). METHODS: In a randomized, double-blinded manner, 100 children, ASA physical status I, aged 4-11 years, received orally placebo or granisetron at three different doses (20 microg x kg(-1), 40 microg x kg(-1), 80 microg x kg(-1)) 60 min before surgery (n=25 of each). The same standard general anaesthetic technique was used. RESULTS: The percentage of patients being emesis-free during 0-6 h after anaesthesia was 56% with placebo, 64% with graniseron 20 microg x kg(-1) (P=0.773), 88% with granisetron 40 microg x kg(-1) (P=0.027) and 92% with granisetron 80 microg x kg(-1) (P=0.01); the corresponding rate during 6-24 h after anaesthesia was 60%, 68% (P=0.768), 92% (P=0.02) and 92% (P=0.02) (P-values versus placebo). No clinically serious adverse events were observed in any of the groups. CONCLUSIONS: In summary, preoperative oral granisetron 40 microg x kg(-1) is effective for the prevention of vomiting following paediatric surgery (inguinal hernia, phimosis-circumcision). Increasing the doses to 80 microg x kg(-1) provides no demonstrable additional benefit.

Administration, Oral↗

PubMed2002

Small dose of propofol for preventing nausea and vomiting after third molar extraction.

PURPOSE: The study goal was to evaluate the efficacy and safety of a small dose of propofol for the prevention of nausea and vomiting following third molar extraction. PATIENTS AND METHODS: In a prospective, randomized, double-blinded, placebo-controlled trial, 90 women received placebo or propofol at 2 different doses (0.25 mg/kg, 0.5 mg/kg) (n = 30 of each) intravenously at the end of surgery. A standard general anesthetic technique, including sevoflurane and nitrous oxide in oxygen, was employed throughout the surgical procedure. Emetic episodes and safety assessments were performed during 0 to 3 hours and 3 to 24 hours after after anesthesia. RESULTS: The rate of patients experiencing emesis-free (no nausea, retching, or vomiting) during 0 to 3 hours after anesthesia was 60% with placebo, 66% with propofol 0.25 mg/kg (P =.395), and 90% with propofol 0.5 mg/kg (P =.001); the corresponding rate during 3 to 24 hours after anesthesia was 60%, 63% (P = 0.5), and 87% (P =.02) (P values compared with placebo). No clinically serious adverse effects due to the study drug were observed in any group. CONCLUSIONS: Prophylactic therapy with a small dose (0.5 mg/kg) of propofol is effective for preventing postoperative nausea and vomiting in female patients undergoing general anesthesia for third molar extractions.

Adolescent↗

PubMed2002

Novel chemiluminescence assay for serum periostin levels in women with preeclampsia and in normotensive pregnant women.

OBJECTIVE: We recently developed a novel sandwich chemiluminescence assay to determine serum concentrations of periostin. Periostin has high amino acid homology with transforming growth factor-beta-induced protein beta igh3, a molecule induced by transforming growth factor-beta(1), which promotes the adhesion and spreading of fibroblasts. It is also homologous with the insect cell adhesion molecule fasciclin I. We determined serum periostin concentrations in women with preeclampsia and in normotensive pregnant women. STUDY DESIGN: The study groups included 30 women with preeclampsia and 30 normotensive pregnant women at Magee-Womens Hospital. Blood samples collected from these women were assayed for periostin by use of newly developed monoclonal and polyclonal antibodies. We studied periostin messenger ribonucleic acid (mRNA) expression in human tissues by using reverse transcriptase-polymerase chain reaction and in situ hybridization. RESULTS: Serum periostin concentrations were elevated in patients with preeclampsia (mean +/- SD, 311.8 +/- 56.3 ng/mL) compared with normotensive pregnant women (218.8 +/- 37.3 ng/mL). No correlation was found between serum concentrations of periostin and concentrations of TGF-beta(1), vascular cell adhesion molecule-1 (VCAM-1), E-selectin, and interleukin-6. Reverse transcriptase-polymerase chain reaction analysis demonstrated human periostin expression in lung, kidney, and placenta but not in the heart, liver, brain, or skeletal muscle. For periostin complementary deoxyribonucleic acid cloned from placenta, there was a splicing deletion within the C-terminal domain. In situ hybridization data showed that the periostin gene was expressed in the stroma cells of placenta. CONCLUSION: Our study suggests that human periostin may play a role in the pathogenesis of preeclampsia. Although its function remains unclear, the expression of periostin as an adhesion molecule could suggest novel mechanisms in preeclampsia.

Adult↗

PubMed2002

Prophylaxis of nausea and vomiting after laparoscopic cholecystectomy with ramosetron: randomised controlled trial.

OBJECTIVE: To evaluate the efficacy and safety of ramosetron (a 5-hydroxytryptamine type 3 receptor antagonist) for the prevention of nausea and vomiting after laparoscopic cholecystectomy. DESIGN: Prospective, randomised, double-blind, placebo-controlled study. SETTING: University and university-affiliated hospitals, Japan. SUBJECTS: 100 patients, 65 women and 35 men, who had laparoscopic cholecystectomy. INTERVENTIONS: Patients were given either placebo or ramosetron at 3 different doses (0.15 mg, 0.3 mg, 0.6 mg) intravenously at the completion of operation. The general anaesthetic technique and postoperative analgesia were standard. MAIN OUTCOME MEASURES: Vomiting and safety were assessed for 0 to 24 hours and 24 to 48 hours after anaesthesia. RESULTS: The number of patients who had a complete response (no nausea, no retching, no vomiting) during 0 to 24 hours after anaesthesia was 15/25 with placebo, 17/25 with ramosetron 0.15 mg, 23/25 with ramosetron 0.3 mg, and 23/25 with ramosetron 0.6 mg; The corresponding numbers from 24 to 48 hours were 16, 17, 23, and 23. No serious adverse events were observed in any of the groups. CONCLUSIONS: Ramosetron 0.3 mg was the minimum effective dose for preventing postoperative nausea and vomiting during 0 to 48 hours after anaesthesia in patients undergoing laparoscopic cholecystectomy.

Antiemetics↗

PubMed2002

Chfr expression is downregulated by CpG island hypermethylation in esophageal cancer.

Cell cycle progression is monitored by checkpoint mechanisms to ensure the integrity of the genome and the fidelity of sister chromatid separation. Failure of such checkpoint functions results in genomic instability, a condition that predisposes cells to neoplastic transformation and tumor progression. Recently, Scolnick and Halazonetis defined a new mitotic checkpoint that acts at prophase and delays chromosome condensation in response to mitotic stress, and identified a gene, named checkpoint with FHA and ring finger (Chfr), that seems to be required for delaying prophase in human cells. In the present study, we examined human Chfr mRNA expression in 15 human esophageal cancer cell lines and 43 primary esophageal cancers to investigate the potential involvement of Chfr in the pathogenesis of esophageal cancers. We report here that a significant proportion of human esophageal cancer has loss of expression of Chfr gene. Furthermore, we found aberrant hypermethylation of the promoter region of this checkpoint gene in four of 15 (26.7%) esophageal cancer cell lines and in seven of 43 (16.3%) primary cancers.

Adenocarcinoma↗

PubMed2002

Beta IGH3, a TGF-beta inducible gene, is overexpressed in lung cancer.

BACKGROUND: Transforming growth factor-beta (TGF-beta) is capable of affecting the proliferation of many cell types. beta IGH3, TGF-beta inducible gene, was originally isolated from lung adenocarcinoma cell line (A549). We have hypothesized that beta IGH3 mRNA levels could be predictors of the development and invasion of lung cancer. METHODS: The study included 71 lung cancer cases. The beta IGH3 mRNA levels were quantified by real time reverse transcription polymerase chain reaction (RT-PCR) using LightCycler. RESULTS: The beta IGH3 mRNA levels were elevated in tumor tissues from lung cancer (1.058 +/- 1.212) compared with non-malignant lung tissues (0.304 +/- 0.159) (p = 0.0001). No significant difference in beta IGH3 mRNA levels was found among gender, age, pathological subtype and lymph node metastasis. The beta IGH3 mRNA levels were elevated in tumor tissues from T4 lung cancer (1.425 +/- 1.470) compared with those from T1 lung cancer (0.702 +/- 0.655) (p = 0.05) and T2 lung cancer (0.736 +/- 0.734) (p = 0.044). CONCLUSION: Using the LightCycler RT-PCR assay, the determination of beta IGH3 mRNA level might provide a potential marker for the aggressiveness of lung cancer. However, further studies and a longer follow-up are needed to confirm the impact of beta IGH3 on the biological behavior of the tumor.

Adult↗

PubMed2002

Decreased peroxisome proliferator-activated receptor gamma gene expression is correlated with poor prognosis in patients with esophageal cancer.

BACKGROUND: Peroxisome proliferator-activated receptor gamma (PPAR gamma) induces apoptosis by ligand stimulation in various tumor cell lines. In esophageal cancer cell lines, PPAR gamma activation also has suppressed the proliferation. METHODS: In 55 primary esophageal squamous cell carcinomas (ESCCs) we examined the correlation between the expression of PPAR gamma mRNA with prognosis of esophageal cancer patients. The expression of PPAR gamma mRNA was quantified by real-time reverse transcription polymerase chain reaction using LightCycler. Immunohistochemistry was used to study the expression of PPAR gamma protein. RESULTS: The expression of PPAR gamma mRNA was significantly decreased in esophageal cancer cells compared with normal esophageal mucosa (P = 0.0084). Among the clinical factors, PPAR gamma mRNA expression was lower in the tumors with extensive lymph node metastasis (n4) than those with less extensive lymph node metastasis (n0-3) (P = 0.0059). Patients with low PPAR gamma mRNA expression had significantly shorter postoperative survival time than those with high PPAR gamma mRNA expression (P = 0.0191). In immunohistochemistry, PPAR gamma protein was expressed in the nuclei of cells in some cases and expressed in the nuclei and cytoplasm in others. The expression of PPAR gamma protein is decreased in esophageal cancer tissue compared with normal esophageal squamous epithelium. However, we could not deduce the apparent relation for the expression between PPAR gamma mRNA and PPAR gamma proteins in immunohistochemistry (P = 0.284). CONCLUSIONS: In esophageal cancer tissues, the expression of PPAR gamma was decreased compared with normal esophageal epithelium. The mRNA expression level of PPAR gamma may be a marker of prognosis after operation in esophageal cancer patients.

Esophageal Neoplasms↗

PubMed2002

Expression of PTTG (pituitary tumor transforming gene) in esophageal cancer.

BACKGROUND: Recently, a vertebrate securin [pituitary tumor transforming gene (PTTG) in humans] has been identified that inhibits sister chromatid separation and is involved in malignant transformation and tumorigenesis. Abundance of this protein would disrupt cell division, generate chromosomal instability and thereby increase cell susceptibility to acquisition of further mutations during subsequent division. Esophageal cancer is a disease with poor prognosis with early local invasion and lymph node metastasis. It is important to identify factors that influence the aggressiveness of esophageal cancer. METHODS: Expression of PTTG messenger ribonucleic acid (mRNA) was evaluated by real-time reverse transcription polymerase chain reaction in 48 esophageal cancer specimens and matched normal esophageal mucosa. The data were analyzed with reference to clinicopathological factors. RESULTS: Tumor tissue expressed a significantly higher level of PTTG1 mRNA than the corresponding normal tissue (P < 0.0001). PTTG1 mRNA expression was significantly higher in tumors with higher pathological stage (IV vs 0-III, P = 0.0442) or more extensive lymph node metastasis (pathological N factor; N4 vs N0-3, P = 0.003). The median survival for patients with high PTTG1 expression (8.5 months) was less than that for patients with low PTTG1 expression (14.0 months, P = 0.039). PTTG1 expression was one of the significant predictors of survival on univariate analysis (hazard ratio 2.225; 95% confidence interval 1.007-4.915). CONCLUSIONS: Detection of high PTTG1 expression in surgically excised esophagus tumor tissues might help to identify patients with aggressive disease who require adjuvant therapy and provide prognostic information.

Aged↗

PubMed2002

The dose-related efficacy of diltiazem for enhancing diaphragmatic fatigability in dogs.

UNLABELLED: Nicardipine, a calcium channel blockade, enhances the production of diaphragmatic fatigue. We studied the dose-related effects of diltiazem, another calcium channel blockade, on diaphragmatic fatigability in dogs. Animals were divided into three groups of eight each. In each group, diaphragmatic fatigue was induced by intermittent supramaximal bilateral electrophrenic stimulation at a frequency of 20 Hz applied for 30 min. During this fatigue-producing period, Group I received no study drug, Group II was infused with diltiazem 0.1 mg. kg(-1). h(-1), and Group III was infused with diltiazem 0.5 mg. kg(-1). h(-1). We assessed diaphragmatic contractility by transdiaphragmatic pressure (Pdi). After the fatigue-producing period, in Group I, Pdi at low-frequency (20-Hz) stimulation decreased from baseline values (P < 0.05), whereas there was no change in Pdi at high-frequency (100-Hz) stimulation. In Groups II and III, with an infusion of diltiazem, Pdi at both stimuli decreased from baseline values (P < 0.05). The decrease in Pdi to each stimulus was more in Group III than in Group II (P < 0.05). We conclude that diltiazem causes a dose-related augmentation of fatigability in the diaphragm of dogs. IMPLICATIONS: Diaphragmatic muscle fatigue is implicated as a cause of respiratory failure. Diltiazem, a calcium channel blockade, enhances diaphragmatic fatigability in dogs in a dose-related manner.

Animals↗

PubMed2002

Flumazenil recovers diaphragm muscle dysfunction caused by midazolam in dogs.

UNLABELLED: We studied the effects of flumazenil on diaphragm muscle dysfunction caused by midazolam in dogs. Animals were divided into three groups of eight each. In each group, anesthetic doses (0.1 mg/kg initial dose plus 0.5 mg. kg(-1). h(-1) maintenance dose) of midazolam were administered for 60 min. Immediately after the end of midazolam administration, Group 1 received no study drug; Group 2 was infused small-dose (0.004 mg. kg(-1). h(-1)) flumazenil; Group 3 was infused with large-dose (0.02 mg. kg(-1). h(-1)) flumazenil. We assessed diaphragm muscle function (contractility and electrical activity) by transdiaphragmatic pressure (Pdi) and integrated electrical activity of the diaphragm (Edi). After midazolam was administered in each group, Pdi at low-frequency (20-Hz) and high-frequency (100-Hz) stimulation decreased from baseline values (P < 0.05), and values of Edi at 100-Hz stimulation were less than those obtained during baseline (P < 0.05). In Group 1, Pdi and Edi to each stimulus did not change from midazolam-induced values. In Groups 2 and 3, with an infusion of flumazenil, Pdi at both stimuli and Edi at 100-Hz stimulation increased from midazolam-induced values (P < 0.05). The increase in Pdi and Edi was more in Group 3 than in Group 2 (P < 0.05). We conclude that flumazenil recovers the diaphragm muscle dysfunction (reduced contractility and inhibited electrical activity) caused by anesthetic doses of midazolam in dogs. IMPLICATIONS: In dogs, flumazenil recovers diaphragm muscle dysfunction (reduced contractility and inhibited electrical activity) caused by midazolam in a dose-related manner.

Anesthetics, Intravenous↗

PubMed2002

Ratio of expression of p16INK4a to p14ARF correlates with the progression of non-small cell lung cancer.

The CDKN2 gene is located on the short arm of chromosome 9p and encodes two unrelated proteins, p16(INK4a) and p14(ARF), through the use of independent first exons and shared exons 2 and 3. p16(INK4a) is a cyclin-dependent kinase inhibitor, whereas p14(ARF) regulates the cell cycle through a p53 and MDM2-dependent pathway. We have examined the expression of p16(INK4a) and p14(ARF) using competitive RT-PCR in 60 non-small cell lung cancers (NSCLCs) and matching normal lung tissues. The intensities of bands for p16(INK4a) and p14(ARF) were nearly equal or the intensity of the p16(INK4a) band slightly exceeded that of p14(ARF) in the normal lung tissues (n = 60). In 38 tumors the intensity of the p16(INK4a) band was similar to or slightly weaker than that of p14(ARF). In 6 tumors the intensity of the p16(INK4a) band was weaker than that of p14(ARF). In 15 tumors the intensity of the p14(ARF) band was very strong and the p16(INK4a) band was barely visible. In only one tumor was the intensity of the p16(INK4a) band very strong, while the band of p14(ARF) was barely visible. The ratio of the intensity of p16(INK4a) to p14(ARF) had an interesting correlation with the tumor's clinicopathological characteristics. The p stage II - IV tumors had significantly lower p16(INK4a) to p14(ARF) ratios than the p stage I tumors (P = 0.036). The T2 - 4 tumors had significantly lower p16(INK4a) to p14(ARF) ratios than the T1 tumors (P = 0.005). The N1 - 3 tumors had significantly lower p16(INK4a) to p14(ARF) ratios than the N0 tumors (P = 0.014). Our results suggest that the ratio of expression of p16(INK4a) to p14(ARF) tends to decrease during the progression of NSCLC.

Adult↗

PubMed2002

p185(HER-2/neu) and p21(CIP1/WAF1) expression in primary tumors and lymph node metastases in non-small cell lung cancer.

p185(HER-2/neu), a tyrosine kinase receptor, is one of the target molecules for cancer therapy, and its expression may reduce the sensitivity of tumor cells to anti-cancer drugs. p21(CIP1/WAF1) is a cyclin-dependent kinase inhibitor, and its expression may also be involved in chemoresistance. Non-small cell lung cancer (NSCLC) is a potentially systemic disease, and systemic therapies play an important role in its treatment. However, there have been no studies comparing the expression of these molecules between primary and metastatic tumors. We investigated the expression of p185(HER-2/neu) and p21(CIP1/WAF1) in 57 paired samples of primary NSCLC tumors and corresponding lymph node metastases by immunohistochemistry. Expression of each of p185(HER-2/neu) and p21(CIP1/WAF1) was highly correlated between primary tumors and lymph node metastases, and similar correlations were also obtained when adenocarcinoma and squamous cell carcinoma cases were analyzed individually. However we failed to detect any correlation between p185(HER-2/neu) and p21(CIP1/WAF1) expression. Our results suggested that expression of both p185(HER-2/neu) and p21(CIP1/WAF1) is concordant between primary and metastatic tumors.

Adult↗

PubMedDate not supplied

Benefits and risks of granisetron versus ramosetron for nausea and vomiting after breast surgery: a randomized, double-blinded, placebo-controlled trial.

Women undergoing general anesthesia for breast surgery are at particular risk of postoperative nausea and vomiting. In a randomized, double-blinded, placebo-controlled trial, 90 patients scheduled for breast surgery, aged 33-63 years, received intravenously placebo, 3 mg granisetron, or 0.3 mg ramosetron (n = 30 of each) at the end of surgical procedure. A standard general anesthetic technique and postoperative analgesia were used. Emetic episodes and safety assessment were performed during 0-24 hours and 24-48 hours after anesthesia. The rate of patients experiencing emetic symptoms (nausea, retching, vomiting) 0-24 hours after anesthesia was 17% with granisetron (P = 0.013) and 10% with ramosetron (P = 0.002) compared with placebo (47%); the corresponding rate 24-48 hours after anesthesia was 27% (P = 0.032) and 7% (P = 0.001), compared with placebo (53%). In the 24-48 hours after anesthesia, there were fewer emetic episodes in patients who had received ramosetron than in those who had received granisetron (P = 0.039). The severity of nausea was less in patients receiving ramosetron than in those receiving granisetron (P = 0.044). Zero to 24 hours after anesthesia, no difference in the rate of patients having emetic symptoms and the severity of nausea was observed between the granisetron and ramosetron groups. The most common reported adverse events were headache and dizziness, and there were no difference in the incidence of adverse events due to the study drug among the 3 groups. In conclusion, prophylactic therapy with ramosetron is more effective than that with granisetron for the long-term prevention of postoperative nausea and vomiting in women undergoing general anesthesia for breast surgery.

Adult↗

PubMedDate not supplied

Treatment of vomiting after paediatric strabismus surgery with granisetron, droperidol, and metoclopramide.

We have compared the efficacy and safety of granisetron, droperidol, and metoclopramide in the treatment of postoperative vomiting (POV) in children scheduled for strabismus surgery. After experiencing POV during the first 3 h after recovery from anaesthesia, 120 patients received intravenously, in a randomized, double-blind manner, granisetron 40 microg/kg, droperidol 50 microg/kg, or metoclopramide 0.25 mg/kg (n = 40 in each group). The patients were then observed for 24 h after administering the study drugs. Emesis-free episodes were more often observed in patients who had received granisetron (88%) than in those who had received droperidol (63%) or metoclopramide (58%; p < 0.05). No clinically serious adverse events were observed in any group. In conclusion, granisetron is more effective than droperidol or metoclopramide in the treatment of POV after paediatric strabismus surgery.

Antiemetics↗